• Journal of Chest Surgery
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• v.34 no.6
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• pp.485-489
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• 2001

Background: The most important factor in preventing sternal complications is stable sternal approximation. We have tried to find the most effective sternal closure method by examining the incidence of sternal dehiscence with or without infection in patients with cardiac surgery through median sternotomy. Material and Method: This study was performed in 489 patients over 45 years of age with median sternotomy for open cardiac surgery. Simple closure with interrupted 6 wires was performed in 159 patients, figure-of-8 closure technique in 119, overlapping interrupted closure using 10 wires in 150, and combined closure technique of interrupted simple closure and figure-of-8 suture closure in 61. Two hundred thirty-four patients underwent valve and aortic operations and 213 patients coronary artery bypass surgery. Result: Sternal dehiscence with or without infection occurred in 12 (2.5 %) patients. The complication developed in 5 of 159 patients (3.1%) with six interrupted simple closure, in 4 of 119 patients (3.4%) with figure-of-8 closure, and in 3 of 150 patients (2.0%) with overlapping interrupted closure using 10 wires, but there was no complication in 61 patients with combined closure technique (relative risk for other closure techniques, p<0.05). There was no significant difference in the incidence of the sternal complication between valve and aortic operation group and coronary artery bypass group (3.0% vs 2.3%, not significant), but diabetes mellitus was a significant independent risk factor (odds ratio and multivariate analysis, p<0.05). Conclusion: The sternal closure technique that combines simple interrupted suture closure and figure-of-8 suture closure may be a more useful technique to enhance sternal stabilization compared to other closure techniques, such as simple interrupted closure, 8-figure closure, and overlapping interrupted closure.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.754-762
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• 2001

Background: To evaluate the efficacy of arterial switch operation for transposition of great arteries, serial echocardiographic studies were performed in 8 patients who underwent the surgery between 1989 and 1998 at Dept. of Thoracic & Cardiovascular Surgery, Yeungnam University Hospital in Daegu City, Korea. Material and Method: Follow-up period ranged from 6 months to 11 years(average of 4.1 years). Body weight ranged from 2.6kg to 4.8kg, with average of 3.6kg. 5 of 8 patients were preoperatively diagnosed as TGA+VSD, and 3 as TGA+IVS. LV function was evaluated by the measurement of LV shortening fraction, LVSTI, and LVEF. RVSTI was also measured. Postoperative function of valve and growth of great vessels were analyzed by the measurement of PSPGV, valvular regurgitation, LA/AO ratio, root dimension of aorta and pulmonary artery, comparing with the age matched controls, respectively. Result: LVEF had an average of 65.0+9.03% which is tended to increase serially. LVAOPG had an average of 15.9mmHg. RVPAPG, 27.5mmHg. From the measurement of aortic root dimension of 6 patients at end-systole, aortic root growth was assumed to increase more than the mean value of normal growth. PA root dimension at end-systole showed a similar growth progress when compared with age matched normal controls. Postoperative pulmonic valve regurgitation was noted in 5 of total 8 patients, in which 1 patient who showed grade 2 and 4 showed below grade 1. AR, in 6 patients and all grade 1 Except 1 patient, all the valvular regurgitations were below grade 1, which was presumed to be clinically insignificant.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.12
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• pp.4721-4726
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• 2010

The performance characteristics of water-chilling heat pump using CO2 for the control of inverter frequency was investigated experimentally. An experimental apparatus is consisted of a compressor, a gas cooler, an expansion valve, an evaporator and a liquid receiver. All heat exchangers used in the test rig are counter flow type heat exchangers with concentric dual tubes, which are made of copper. The gas cooler and the evaporator consist of 6 and 4 straight sections respectively arranged in parallel, each has 2.4m length. The experimental results summarize as the following: for constant inlet temperature of evaporator and gas cooler, as mass flow rate, compression ratio and discharge pressure increases with the inverter frequency. And heating capacity and compressor work increases, but coefficient of performance(COP) decreases with the inverter frequency of compressor. As inlet temperature of secondary fluid in the evaporator increases from $15^{\circ}C$ to $25^{\circ}C$, compression ratio and compressor work decreases, but mass flow rate, heating capacity and COP increases with the inverter frequency of compressor. The above tendency is similar with performance variation with respect to the variation of inverter frequency in the conventional vapor compression refrigeration cycle.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.213-221
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• 1990

We have experienced 62 cases of modified Fontan operations in Seoul Nat’l University Hospital from Apr. 1986 to Jul. 1989, They were 38 males and 24 females, and their age was ranged from 16 months to 15.5 years of age. [mean age : 5.73$\pm$2.99 years] There were 16 operative deaths and 2 late deaths, therefore 29% of overall mortality. Their diagnoses were as follows; 28 single ventricle, 11 tricuspid atresia, 6 DORV with LV hypoplasia, 3 pulmonary atresia with hypoplastic RV, 3 TGA with hypoplastic RV, 3 cor\ulcornerGA with hypoplastic LV and PA, 6 AV canal defects with PA, and 2 others. Low cardiac output and pleural effusion were developed frequently, so we divide 40 patients into some groups to analyze the physiologic and anatomic causes of them. By the degree of the LCO, group A was no LCO[mean amount of inotropics used: 0-5 \ulcornerg/kg/min] with 17 cases, B mild LCO [5-10] with 11, C moderate to severe LCO but alive[>10] with 8, D severe LCO to death with 4 cases. For the pleural effusion, group 1 was to be removed the chest tube within 1 week with 8 cases, group II within 3 weeks with 21 cases, group III beyond 3 weeks with 12 cases. We considered their age, diagnosis, pulmonary artery size[PA index], pulmonary artery abnormality, palliative shunt, systemic ventricular type, pulmonary artery wedge pressure, as preoperative factors, and operative methods, and as postoperative factors, CVP, LAP, arrhythmia, thrombosis, atrioventricular valvular insufficiency, etc. In the view of LCO, pulmonary artery size and PCWP were statistically significant [P<0.05], and arrhythmia, A-V valve insufficiency were inclined to the group C and D Pleural effusion was influenced by the pulmonary artery size, pulmonary artery resistance, PCWP, and CVP significantly. [P<0.05] And arrhythmia, residual shunt, and A-V valvular insufficiency were inclined to group II and III, too. As a results, the followings are to be reminded as the important factors at the care of post-Fontan LCO, and persistent pleural effusion [1] pulmonary artery size, [2] pulmonary artery resistance, [3] PCWP, [4] CVP, [5] arrhythmia, [6] residual shunt, [7]A-V valvular insufficiency.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.1004-1008
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• 1998

We report a case of heart-lung transplantation in a 32 year-old female with Eisenmenger syndrome secondary to patent ductus arteriosus. She has been suffered from congestive heart failure since June 1996 and repeatedly treated at Intensive Care Unit with intravenous inotropic support since July 1997. Preoperative echocardiography showed a patent ductus arteriosus with right to left shunt, severe regurgitation of tricuspid valve and estimated right ventricular systolic pressure of 100mmHg. The brain-dead donor was an 18 year-old male with head trauma from traffic accident 3 days ago. Heart-lung block procurement was performed at another general hospital and was transported to the Seoul National University Hospital by ambulance. Total ischemic time of the transplanted heart and lung were 249 minutes and 270 minutes, respectively. The immunosuppressive therapy was commenced preoperatively with cyclosporine and azathioprine. Corticosteroid was not used until postoperative 3 weeks in order to avoid infection and delayed healing at the tracheal anastomotic site. The patient was discharged at 31st postoperative day, and has been regularly followed up at outpatient clinic without specific complication. The follow-up bronchoscopy, performed 2 weeks and 4 months after surgery, revealed no evidence of cellular rejection.

• Journal of the Korean Institute of Gas
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• v.22 no.4
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• pp.39-48
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• 2018

This study presents optimal design of gas lift considering composition of reservoir oil and injected gas which can affect gas lift performance in offshore oil reservoir. Reservoir simulation was conducted by using reservoir models which were built in accordance with API gravity of oil. The results of simulation reveal that oil production rate is considerably increased by gas lift when the reservoir productivity decrease. As a results of response curve analysis for gas lift using well models, gas injection rate to improve the production rate increases as the API gravity of oil decreases and the specific gravity of injected gas increases. The optimal design of gas lift was carried out using multiple lift valves. Consequently, gas lift can be operated at relatively low injection pressure because of decrease in injection depth in comparison to the single lift valve design. The improved oil production rates were analyzed by coupling between reservoir model and well model. As a results of the coupling, it is expected that natural gas injection in the heavy oil reservoir is the most efficient method for improving oil production by gas lift.

• Journal of Yeungnam Medical Science
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• v.14 no.2
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• pp.350-358
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• 1997

We studied the effects of adding a single bolus(500 mg) of sodium thiopental to a continuous infusion of low-dose fentanyl on plasma beta-endorphin immunoreactivity(iBE) responses to cardiopulmonary bypass(CPB) in 28 patients undergoing elective coronary artery bypass grafting or valve procedures. Thiopental was injected just prior to the initiation of CPB. The iBE levels and the hemodynamic indices such, as mean arterial pressure, cardiac output and systemic vascular resistance were measured before CPB, at 30 min and again at 60 min after the initiation of the bypass. The results were as follows. After the initiation of CPB, iBE levels increased at 30 min and 60 min(P=0.006, P=0.004 respectively) in the control group, but not in the thiopental group. There were significant differences in the changes of iBE levels between the groups(F=8.7, G-G=0.002, P=0.001). The hemodynamic indices were similar in both groups. In conclusion, pretreatment with thiopental just before the initiation of CPB prevents the stress-induced beta-endorphin response to CPB.

• Journal of Energy Engineering
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• v.25 no.4
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• pp.124-132
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• 2016

In order to estimate the effect of flow distributors connected to an upper nozzle of CMT(Core Makeup Tank) on the thermal-hydraulic characteristics in the tank, a simplified 2 inch Small Break Loss of Coolant Accident(SBLOCA) was simulated by skipping the decay power and Passive Residual Heat Removal System(PRHRS) actuation. The CMT is a part of safety injection systems in the SMART (System Integrated Modular Advanced Reactor). Each test was performed with reliable boundary conditions. It means that the pressure distribution is provided with repeatable and reproducible behavior during SBLOCA simulations. The maximum flow rates were achieved at around 350 seconds after the initial opening of the isolation valve installed in CMT. After a short period of decreased flow rate, it attained a steady injection flow rate after about 1,250 seconds. This unstable injection period of the CMT coolant is due to the condensation of steam injected into the upper part of CMT. The steady injection flow rate was about 8.4% higher with B-type distributor than that with A-type distributor. The gravity injection during hot condition tests were in good agreement with that during cold condition tests except for the early stages.

• Journal of the Korean Institute of Intelligent Systems
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• v.3 no.2
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• pp.18-35
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• 1993

The water level control system of the steam generator in a pressurized water reactor and its control problems are analysed. In this work the stable control strategy during the low power operation and transient states is studied. To solve the problem, a fuzzy logic control method is applied as a basic algorithm of the controller. The control algorithm is based on the operator's knowledges and the experiences of manual operation for water level control at the compact nuclear simulator set up in Korea Atomic Energy Research Institute. From a viewpoint of the system realization, the control variables and rules are established considering simpler tuning and the input-output relation. The control strategy includes the dynamic tuning method and employs a substitutional information using the bypass valve opening instead of incorrectly measured signal at the low flow rate as the fuzzy variable of the flow rate during the pressure control mode of the steam generator. It also involves the switching algorithm between the control valves to suppress the perturbation of water level. The simulation results show that both of the fine control action at the small level error and the quick response at the large level error can be obtained and that the performance of the controller is improved.

• Journal of the Korean Society for Aeronautical & Space Sciences
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• v.43 no.6
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• pp.548-556
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• 2015

The highly maneuverable fighter aircraft such as F-22, F-16 and F-15have the high maneuverability to maximize the combat performance, whereas the high maneuver characteristics might degrade the pilot's mission efficiency due to fatigue's increase by exposing him to the high gravity and, in the worst case, the pilot could face GLOC (Gravity-induced Loss Of Consciousness). The advanced aerospace company has applied the various technologies to improve the pilot's tolerance to the gravity acceleration, in order to prevent the pilot from entering the situation of the loss of consciousness. Especially, the Anti-G Suit(AGS) equipment to protect the pilot against the high gravity in flight could improve the mission success rate by decreasing the pilot's fatigue in the combat maneuver as well as prevent the pilot from facing GLOC. In this paper, a control algorithm is developed and verified to provide an optimal air pressure to AGS according to the gravity increase during the high performance maneuver. This result is expected, as the key technology, to contribute to the KF-X(Korean Fighter eXperimental), project in the near future.